Kornimate/medical-research-clean huggingface dataset:
increasing the uptake of influenza and pneumococcal vaccines among high-risk adult patients through gp clinics

Conditions: Immunization Programs

Summary: pneumonia and influenza are among the top causes of hospitalisation and death in the elderly. while vaccinations are recommended against these diseases, a large proportion of elderly in the community remain unvaccinated, with approximately only 10% vaccinated for either disease. in this study, the investigators aim to implement an intervention package within gp clinics to increase influenza and pneumococcal vaccination rates, especially among elderly patients with chronic diseases.

influenza and pneumococcal disease contribute considerably to hospitalisation and mortality in the elderly. while recommended vaccines can reduce disease burden, vaccine uptake remains very low in singapore, with approximately only 10% of elderly appropriately vaccinated for either disease. improving vaccine uptake rates could be effected through private sector primary care clinics, which are highly accessible in singapore. an intervention bundle we piloted in one clinic comprised physician reminders and patient-targeted posters and brochures. influenza and pneumococcal vaccine rates both increased by \>30% over the baseline, although half of eligible patients remained unvaccinated. there is thus scope to devise a more effective intervention bundle and demonstrate its efficacy through a more robust and generalisable study design. this study aims to evaluate the efficacy of an intervention bundle deployed in general practice clinics to promote influenza and pneumococcal vaccine uptake among elderly patients. the intervention bundle components include educational materials such as posters and flyers, which also serve as reminder slips for attending physicians. the intervention will be implemented in a two-arm cluster randomised crossover trial in up to 30 primary care clinics. control arm clinics will receive no interventions. clinics will be randomised into either of the two arms for a period of 3 months, followed by a washout of 1 month before a crossover is performed. the investigators will subsequently compare vaccination rates during intervention and control periods to provide evidence for effectiveness of the intervention.

Eligibility criteria:
inclusion criteria: * patients seen at gp clinics involved in our study and * aged 65 years and above, with or without chronic disease exclusion criteria: * patients not seen at gp clinics involved in our study * patients aged below 65 years old

Keywords: influenza vaccines pneumococcal vaccines primary health care health communication cross-over studies randomized controlled trial
assessment of the analgesic effects of pf-06372865 in healthy volunteers using evoked pain endpoints

Conditions: Healthy

Summary: this study will examine the activity of 2 different doses of pf-06372865 on a panel of evoked pain tests carried out from 0.5 to 10 hours following oral dosing in healthy male subjects.


Eligibility criteria:
inclusion criteria: * healthy male subjects between the ages of 18 and 55 years, inclusive. healthy is defined as no clinically relevant abnormalities identified by a detailed medical history, full physical examination, including blood pressure and pulse rate measurement, 12 lead ecg or clinical laboratory tests. * body mass index (bmi) of 17.5 to 30.5 kg/m2; and a total body weight \>50 kg (110 lbs). * evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study. * subjects who are willing and able to comply with all scheduled visits, treatment plan, laboratory tests, and other study procedures. exclusion criteria: * evidence or history of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurologic, or allergic disease (including drug allergies, but excluding untreated, asymptomatic, seasonal allergies at the time of dosing). * any condition possibly affecting drug absorption (eg, gastrectomy). * a positive urine drug screen.

Keywords: pain evoked pain healthy volunteer pharmacodynamics
12 weeks of water aerobics at various intensities for adults and older adults

Conditions: Healthy

Summary: the objective of this clinical trial is to understand the best intensity to perform water aerobics with adults and older adults. the main questions it aims to answer are: * is water aerobics performed at high intensity better than water aerobics performed at moderate intensity? * is performing water aerobics for 12 weeks good for muscle strength, body composition (body weight, fat mass), lipid profile (triglycerides, cholesterol), blood pressure, and quality of life in adults and older adults? participants need: * perform water aerobics at high or moderate intensity, twice a week, 45 minutes per class, for 12 weeks * be evaluated in the week before starting the water aerobics program (week 0) and at the end week of the program (week 12) regarding muscle strength, body composition, lipid profile, blood pressure, and quality of life it was hypothesized that independently of the level of intensity used, all variables would improve after water aerobics. it was also expected to observe more gains in all parameters in high-intensity water aerobics compared to moderate intensity


Eligibility criteria:
inclusion criteria: * at least 18 years of age exclusion criteria: * taking part in another physical exercise program * being recently hospitalized * having severe motor or cognitive problems * having any medical restrictions on physical exercise

Keywords: aquatic exercise intensity physical fitness health-related quality of life
study on optimization and evaluation of integrated chinese and western medicine for pss glandular damage

Conditions: Primary Sjögren Syndrome

Summary: chatgpt in a randomized controlled trial, 136 patients with primary sjögren's syndrome (pss) meeting the inclusion criteria were enrolled and randomly divided into two groups of 68 each. the treatment group received an optimized program combining chinese and western medicine for pss glandular injury, while the control group received a conventional program for pss glandular damage. the primary efficacy endpoint was the 12-week non-stimulated salivary flow rate (uws) score. secondary efficacy endpoints included the glandular damage visual analog scale (vas) scores, the european sjögren's syndrome patient reported index (esspri), among others. the treatment course lasted 12 weeks. the efficacy and safety of the optimized program for pss glandular injury were evaluated by comparing within and between groups before and after treatment.


Eligibility criteria:
inclusion criteria: * 1. clinical diagnosis of pss and qi and yin deficiency ; 2.sign the informed consent form. exclusion criteria: * 1. pss activity system damage (essdai score ≥5); 2. combined connective tissue diseases other than pss; 3. pregnant or lactating women; 4. severe cardiovascular and cerebrovascular diseases, liver and kidney failure, and severe malignant tumors; 5. taking psychotropic drugs; 6. assessed by the investigator to be ineligible for enrollment.

Keywords: randomized controlled trial
utility of the history and physical exam in the emergency department

Conditions: Abdominal Pain; Back Pain; Dyspnea; Headache; Weakness

Summary: the study is trying to prove that the history and physical exam (h\&p) in the emergency department is the most important tool in exam of patients. the investigator is attempting to correlate the time of the h\&p of residents and attendings to the accuracy of diagnosis.

the purpose of the study is to examine the utility of the history and physical exam in the emergency room towards obtaining a diagnosis. the goal of this observational study is to correlate physician level of experience and time spent on history and physical exam, to the correct diagnosis. the aim of this study is: 1. to draw a connection between time and accuracy of the history and physical exam. 2. to draw a connection between time and level of experience as a physician based on post-graduate level. 3. to assess the number of laboratory and radiographic studies and the post-graduate level. 4. to assess the relevance of the labs and radiographs ordered. (relevance is defined as something that changes plan of care.) time is a critical component of the ed physician. our study will analyse if modern medicine has created a more laboratory/image based need to ascertain a diagnosis or if history and physical examination alone can predict the ultimate diagnosis.

Eligibility criteria:
inclusion criteria: * anyone over the age of 18 with a generalized complaints able to provide consent exclusion criteria: * anyone under 18 yrs and anyone with a very specific, system based complaint.
management of giant thoracic disc hernias by thoracoscopy: experience of 52 cases

Conditions: Giant Thoracic Herniation; Myelopathy

Summary: introduction: giant thoracic disc herniation is a rare condition for which surgical treatment is indicated when there are signs of spinal cord injury. to date, several surgical techniques have been described in the treatment of this condition on small patient series. the main objective is to evaluate the long-term results of a series of 53 patients treated with a minimally invasive endoscopic procedure. the secondary objective is to explain our pre-operative planning and the technical details of our procedure. method: retrospective monocentric study on a cohort of patients treated in our department. the following medical data from our database are analyzed: morbidity of operative gesture (duration of procedure, bleeding, postoperative complications), clinical results at the last follow-up visit (thoracic japanese orthopedic association (joa) score, frankel score, parietal pain , ability to walk, wish to carry out the same intervention again if necessary). on the radiological level, we evaluated the quality of the resection (total, subtotal, incomplete and impossible), the reappearance of a border of cerebrospinal fluid perimedullary and the presence of an intramedullary t2 hyperintense signal mri post- operative. all these data are collected and analyzed anonymously. expected results: we believe we can demonstrate that thoracoscopy is a valid therapeutic option in the treatment of thoracic disc herniation responsible for spinal cord compression. this with a low morbidity given the minimally invasive nature of the approach.


Eligibility criteria:
inclusion criteria: * patient operated on giant thoracic thoracic disc herniation between may 2001 and october 2016 exclusion criteria: * none

Keywords: spinal thoracic herniation surgery endoscopic approach thoracic spine minimal invasive access
large-scale brain organization during cognitive control in adhd

Conditions: Attention Deficit Hyperactivity Disorder

Summary: the purpose of this study is to test whether children with attention-deficit/hyperactivity disorder (adhd) are impaired in the ability to flexibly adapt brain network organization in response to shifting cognitive demands during the exertion of cognitive control, by assessing changes in network dynamics resulting from stimulant administration in children with adhd, and how those changes relate to behavioral and symptom improvements. subjects will be children with adhd aged 8-12. subjects will participate in multiple testing sessions that include: diagnosis and eligibility screening, neuropsychological and behavioral testing, and, if eligible, mri scans and a medication challenge. children with adhd who are enrolled in the medication challenge will undergo one mri scan on placebo and one mri scan on stimulant medication, counterbalanced and double-blind. functional connectivity will be measured using functional mri and innovative graph theoretical analytic tools will be implemented. network metrics will be related to symptomatology and behavioral testing measures. it is hypothesized that stimulant administration in children with adhd will increase flexibility in network reconfiguration in response to changing cognitive control demands as compared to when they are on placebo. it is further hypothesized that the degree to which brain network organization is changed will be related to the degree of improvement in cognitive control performance.


Eligibility criteria:
inclusion criteria: * between 8-12 years old * diagnosis of adhd (for adhd group); adhd group only can have comorbid diagnostic and statistical manual of mental disorders (dsm-iv) diagnoses of oppositional defiant disorder, conduct disorder, depressive disorders, or anxiety disorders * adhd subjects must never have been treated with medication for their adhd exclusion criteria: * wechsler intelligence scale for children-fifth edition full-scale intelligence quotient (iq) \< 80 * wechsler individual achievement test-third edition word reading \< 85 * any neurologic or developmental disabilities * any reading or learning disabilities * visual impairment that cannot be corrected-to-normal * color blindness * documented hearing impairment greater than 25 decibels (db) loss in either year * have already gone through puberty (tanner stage ii or higher) * medical contraindication to mri * any psychoactive medication

Keywords: methylphenidate functional connectivity graph theory cognitive control
stem cell therapy in chronic ischemic heart failure

Conditions: Myocardial Ischemia; Heart Failure, Congestive

Summary: the purpose of this study is to determine whether intracoronary bone marrow transplantation can improve left ventricular ejection fraction in patients with severe ischemic heart failure and no other option for standard therapies (revascularization and drugs).

despite standard therapies (revascularization and drugs), patients with severe ischemic heart failure have a high morbidity and mortality. the purpose of this study is to determine whether intracoronary transfer of autologous bone marrow cells can induce angiogenesis, subsequently improving regional myocardial perfusion, and finally resulting in improved systolic and diastolic left ventricular function in patients with severe ischemic heart failure. 35 patients with stable left ventricle function will - with four months interval - receive two treatments with bone marrow transplantation intracoronary in vessels supplying dysfunctional myocardial territories. echocardiography is performed three times prior (four and two months and just before) and two times after (four and eight months after) therapy. it is a non-randomised trial, patients will enter as their own control.

Eligibility criteria:
inclusion criteria: 1. severe ischemic heart failure and no other other option for standard therapies (revascularization and drugs), 2. stable left ventricular ejection fraction \< 40%, 3. ccs class 2-3 and/or nyha class 2-3, and 4. signed informed consent. exclusion criteria: 1. implantation of pacemaker (including implantable cardioverter defibrillator \[icd\] and biventricular pacing), 2. acute myocardial infarction within 3 months, 3. atrial fibrillation, or 4. severe comorbidity that could impact the patient's short-term survival (including primary hematologic disorders)

Keywords: bone marrow transplantation
a study of t3 therapy in patients with hypothyroidism

Conditions: Hypothyroidism

Summary: the purpose of this study is to test a new thyroid hormone preparation. the thyroid gland produces two thyroid hormones: mostly t4 and a smaller amount of t3. thyroid hormone therapy for hypothyroidism or thyroid cancer is generally provided using levothyroxine, which is a synthetic form of t4. t4 is converted into the active hormone t3 in the circulation. therefore, some researchers believe that t3 levels in t4-treated patients may be slightly lower than in individuals whose own thyroid gland is functioning normally. symptoms of hypothyroidism have been suggested to occur because of this possible t3 deficiency, although this is controversial. studies of t3, added to or substituted for t4 in traditional levothyroxine regimens, have generally not shown any benefit of t3. however, it is still possible that no benefit is seen because of the short duration of action or "half-life" of t3. this short-life makes it necessary to dose t3 twice or three times daily. despite multiple daily doses of t3, t3 levels during its therapy tend to be troubled by peaks and troughs. these peaks can be associated with symptoms of excessive thyroid hormone levels. this study will look at tsh and thyroid hormone levels following a daily dose of a new preparation of t3 that may have longer duration of action than liothyronine. this preparation of t3 is called thyromax® or bct303. the investigators believe that steady levels of t3 will be seen after taking thyromax®. the investigators believe that in patients with hypothyroidism use of thyromax® in the correct dose will produce normal tsh levels, without producing symptoms of too much thyroid hormone. the goal of future studies is to test whether thyromax® may be a potential treatment for hypothyroidism, by comparing it with traditional levothyroxine therapy.


Eligibility criteria:
inclusion criteria: * hypothyroid patients taking levothyroxine * age 18-65 * able to make weekly in-person visits to washington, d.c. exclusion criteria: * pregnancy or lactation * chronic medical conditions such as heart disease or any other chronic medical conditions such as lung disease (e.g. asthma), kidney disease (e.g. kidney failure), liver disease (e.g. hepatitis), diabetes, or cancer. * steroid medications such as estrogen, progesterone, estrogen or progesterone related medications, testosterone, or glucocorticoids * already taking t3
intranasal insulin and glutathione as an add-on therapy in parkinson's disease

Conditions: Parkinson Disease

Summary: this study will be evaluating the safety and efficacy of insulin and glutathione in subjects with parkinson's disease compared to placebo.


Eligibility criteria:
key inclusion criteria: * documented clinical diagnosis of idiopathic pd * modified hy stage \< 5 * able to administer study drug or have a caregiver throughout the duration of the study to help administer drug * willing to continue diet, exercise and medications reported at baseline consistently throughout participation in the trial. essential changes are permitted * if taking pd medications or any nutraceuticals, must be on a stable dose for at least 30 days prior to screening visit. essential changes will be permitted. * if subject is taking chronic antidepressant or an anxiolytic, must be on a stable dose for at least 90 days prior to screening. essential changes will be permitted. key exclusion criteria: * clinical diagnosis of type 1 or type 2 diabetes mellitus * glycated hemoglobin (hba1c) level ≥ 6.5% * history of hypoglycemia and/or documented plasma glucose levels of ≤ 50 mg/dl with or without symptoms of hypoglycemia * mini-mental state exam (mmse) score of ≤ 24 at screening * positive covid-19 test at screening and/or within 30 days of screening * change in or escalation of dose of a chronic therapeutic agent that has the potential to impair cognitive functioning * chronic inflammation of nasal cavity that may prevent absorption of study treatments * insufficiently controlled respiratory disease (i.e., asthma, copd). * history of any significant neurologic or psychiatric disease other than pd * current diagnosis of epilepsy and had a history of seizures as an adult within 1 year of screening, or unexplained recent loss of consciousness, or history of significant head trauma with loss of consciousness * history of non-lacunar ischemic and/or hemorrhagic stroke * unstable or uncontrolled cardiac disease that could expose the subject to additional safety risks * use of the following medications: insulin or any other anti-hyperglycemic agent(s) except if used during isolated gestational diabetes, supplementation with gsh or any medication shown to increase glutathione, and beta blockers

Keywords: insulin glutathione intranasal
cyclophosphamide versus methotrexate for remission maintenance in systemic necrotizing vasculitides

Conditions: Wegener's Granulomatosis; Churg-Strauss Syndrome; Microscopic Polyangiitis; Polyarteritis Nodosa

Summary: the systemic necrotizing vasculitides (snv) encompass a group of rare diseases which include wegener's granulomatosis (wg), churg-strauss syndrome (css), microscopic polyangiitis (mpa)and polyarteritis nodosa (pan). common histological findings are inflammation with fibrinoid necrosis of the small vessels and sporadic or absent immune-deposits. the gold standard therapy for snv is currently represented by the association of cyclophosphamide and prednisone. the limits of this approach are the high frequency of recurrent disease and an increased incidence of malignancy and infections. the aim of the present study is to compare the efficacy of methotrexate vs cyclophosphamide for remission maintenance in snv.


Eligibility criteria:
inclusion criteria: * diagnosis of clinically active snv * life-expectancy \> 1 year * written informed consent exclusion criteria: * creatinine clearance \< 10 ml/min/1.73 mq * aminotransferase levels more than twice the upper limit of the normal range * hbsag positivity * anti-hcv ig and hcv-rna positivity * hiv positivity * active malignancies * coexistence of connective tissue disease * prednisolone, cyclophosphamide or methotrexate hypersensitivity * pregnancy

Keywords: vasculitis cyclophosphamide methotrexate systemic necrotizing vasculitides
study to evaluate the long-term safety of etrolizumab in participants with moderate to severe ulcerative colitis

Conditions: Ulcerative Colitis

Summary: this study is an open-label extension (ole) trial to evaluate the safety and tolerability of etrolizumab in participants with moderate to severe ulcerative colitis (uc) who were enrolled in the phase ii study abs4986g (nct01336465) and meet the eligibility criteria for entry in the ole study.


Eligibility criteria:
inclusion criteria: * all participants (placebo or active) who were previously enrolled in the phase ii study (abs4986g) and fulfill any of the following criteria: * participants who have not obtained a clinical response in the phase ii study (abs4986g) by week 10 (the end of the phase ii treatment phase) may enter this ole trial at any time after week 10 and up to and including week 28 * participants who have a clinical response in the phase ii study (abs4986g) at week 10 but have had a flare of uc between week 10 and week 28 * males and females with reproductive potential must be willing to use a highly effective method of contraception, vaginal ring, intrauterine device, physical barrier, or vasectomized partner) from study start to a minimum of 4 months (approximately 5 half-lives) * concomitant immunosuppressive therapy must be tapered within 6 weeks after enrollment in this ole study * participants must have tapered completely off oral corticosteroids within 24 weeks of enrollment to this ole study exclusion criteria: * participants who did not complete through week 10 of the phase ii study (abs4986g) * pregnancy or lactation * any new malignancy within the past 6 months * any new (since enrolling in the phase ii study \[abs4986g\]), significant, uncontrolled, co- morbidity, such as neurological, cardiac, pulmonary, renal, hepatic, endocrine, or gastrointestinal (gi) disorders * any new clinically significant signs or symptoms of infection as judged by the investigator * any abnormal laboratory values recorded at the last visit completed in the phase ii study (abs4986g)